A National Initiative to Reduce Child Abuse and Neglect Fatalities and Injuries Through a Collaborative, Community-Based Approach
Children in the U.S. are healthier and safer than ever before, and medical advances in treating childhood diseases have made enormous strides over the last few decades. Although the overall U.S. child mortality rate has improved over time, the number of child deaths due to abuse and neglect has remained steady or even increased. Each year, somewhere between 1,750 to 3,500 children die from maltreatment. The children who die are quite young. In 2018, 71% of all children who died from maltreatment were younger than three years old. Almost one-half of the children are younger than one year old.
Like other causes of childhood illness and death, child maltreatment can be prevented, and the associated risk factors can be addressed. Child maltreatment deaths are not inevitable. This was the message delivered in a groundbreaking report from the U.S. Commission to Eliminate Child Abuse and Neglect Fatalities. In its 2016 report Within Our Reach: A National Strategy to Eliminate Child Abuse and Neglect Fatalities, the commission provided a blueprint for a public health approach that identifies and addresses the root causes of child maltreatment, engages with multiple stakeholders to address these causes collaboratively, and is a shared responsibility between families and communities.
In October 2019, the U.S. Department of Justice, Office of Justice Programs, Office for Victims of Crime launched Child Safety Forward, a three-year demonstration initiative to develop multidisciplinary strategies and responses to address serious or near-death injuries as a result of child abuse or neglect and to reduce the number of child fatalities. The efforts will be responsive to the 21st-Century Child Welfare System as envisioned by the federal commission and will result in models for coordinated responses. Within Our Reach, an office at the Alliance for Strong Families and Communities that is supported by Casey Family Programs, serves as the national technical assistance provider to the five demonstration sites.

The five participating sites are:
- St. Francis Hospital in Hartford, Connecticut
- Cook County Health in Illinois
- Indiana State Department of Health
- Michigan Department of Health and Human Services
- Sacramento County’s Child Abuse Prevention Council in California
The sites are receiving technical assistance from a team of national experts that is geared toward helping them plan and implement an all-systems approach and coordinated strategic planning to respond to and reduce their child maltreatment fatalities and child crime victimization. It will support them in improved data collection and analysis using a safety science approach, development of strong community collaboratives, engagement of persons with lived experiences, and developmental evaluation.
Planning Year Evaluation Brief
This evaluation brief offers insights on the learning that took place during the planning year of the Child Safety Forward initiative. It identifies four opportunities for the field that, when addressed, will accelerate the advancement of a 21st-century child and family well-being system.
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